Joint Agency Medicines Support Service
Background:
This is a joint initiative between Devon Social Services, the 6 Primary Care Trusts (PCTs), and the Local Pharmaceutical Committee involving independent sector and in-house Domiciliary Care Providers.
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Aim:
The aim of this service is to provide a more person-centred medicines support service that promotes independence and facilitates the care of people in their own homes through the use of common policy, procedures and improved assessment.
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Why we need it:
- It will improve the quality of assessment for Service Users and provide them with a service that is more appropriate and efficient in meeting their needs in the management of their medicines.
- It contributes to the National Service Frameworks (NSF) requirement for improved medicines management by PCTs and the Domiciliary Care National Minimum Standards’ requirement to have clear policy and procedures around this area of work in place.
- It will assist in meeting performance indicators/targets around emergency admissions and supporting people at home.
- There is potential for cost benefits to the PCTs in terms of reduction in medicines wastage, reduction in use of monitoring dose systems (MDS), and more efficient use of Community Nurse time in addition to the reduction in emergency admissions.
- It will mean more efficient use of staff time and facilitate the development of Generic Health / Social Care workers at different levels, which will also begin to create a career path for domiciliary care assistants.
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The Service:
Concordance Assessment
There is currently no broad-based assessment process in place to assist in the identification of an individual’s ability to manage their own medication.
The proposed service includes a new assessment tool focusing on this area of need, to be used by appropriately trained health or social services personnel to determine the reason for non-compliance and the category of intervention required.
The outcome of the concordance assessment will indicate the type of assistance required. This might be
- a simple adaptation to a medicines container
- aids to assist with administration of the medicine, or
- a range of support service provided by domiciliary care staff as outlined below:
Category 1 Assistance - a person on medication requires help in ordering and collecting prescriptions and needs advice on safe storage of medicines.
Category 2 Assistance - a person on medication, requires help to open containers and/or reminding to take medication, ordering and collecting prescriptions and advise on safe storage
Category 3 Assistance - a person on medication, requires supervision with self-medication or total medication management that may include some direct administration.
A fourth category of service is also planned which will be delivered by Health / Social Care Support Workers, a role that is in the process of being developed through the Accelerated Development Programme.
Category 4 Assistance - a person on medication requires total medication management which may include direct administration and some invasive procedures.
The assessor will make a referral to the Domiciliary Care Service who will provide the required service for categories 1 - 3.
All staff delivering this service will have been trained and assessed as competent to carry out the tasks involved and, in particular for category 3, will work closely with community nurses.
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Development Plan:
- The steering group, formed in October 2003 have presented a business case for progressing this work to the Joint Adult Services Management Board / PCT.
- Funding has been agreed for 2004 / 05 in order to pilot the model and process within one GP surgery area, which will be subject to a comprehensive, independent evaluation in order to determine potential costs and benefits before any rollout takes place.
- We have consulted various people/groups across Health, Social Care, Pharmacists, UNISON and the Independent Sector in producing a policy and procedural guidance which will be finalised following the outcomes of the pilot where Service Users and their Carers will also be involved.
- Training plans are being finalised to include specific medicines awareness and administration guidance and the concordance assessment training for staff involved in assessment or review of individual’s needs.
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Steering Group membership:
- Jennie Stephens - Chair (Health and Social Services Policy Officer for North / East PCTs)
- Derek Fish - (Modernisation & Best Value Team - Workforce Development and ADP link)
- Tim Pitcher - (Medicines Management Coordinator for North / East PCTs)
- Caroline Connett - Pilot Project Manager (Local Pharmaceutical Committee link)
- Pauline Stott - (UNISON rep.)
- Kevin Muckian - (Community Pharmacist from Teignbridge)
- Roy Smith - (Training Manager Social Services)
- Diana Brown - (Independent Sector Domiciliary Care Provider - Community Careline Tiverton)
- Carol Barkwell - (Independent Sector Domiciliary Care Provider - Lyndridge Care, Okehampton)
- Rachel Holmes - (Domiciliary Care Manager - In House Provider)
- Del Cathery - Programme Manager (Modernisation & Best Value Team - Domiciliary Care)
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See also:
(The following papers are all in draft form)
Contact:
For further information or to give your views on the project:
- Del Cathery Tel. 01392 462011 - mobile: 07748 147307 - e-mail: dcathery@devon.gov.uk
- Tim Pitcher Tel. 01392 449764 - e-mail: tim.pitcher@middevon-pct.nhs.uk
Also on devon.gov.uk
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